Study: Dementia care costs more than treating heart disease or cancer

By Karen Kaplan, Los Angeles Times •April 4, 2013 12:27 pm

LOS ANGELES — The financial toll of caring for Americans with dementia adds up to at least $159 billion a year, making it more expensive than treatments for patients with heart disease or cancer, according to a new report in the New England Journal of Medicine.

Dementia is characterized by a group of symptoms that prevent people from carrying out the tasks of daily living. Reduced mental function makes it impossible for them to do things like keep track of their medications or their finances. In more severe cases, patients lose the ability to handle basic tasks like bathing and dressing. Dementia is considered a chronic disease of aging, and there is no cure.

Medical bills for dementia patients are comparatively small, amounting to 16 percent to 25 percent of the total tally, according to researchers from RAND Corp. and their collaborators. By far, the most expensive part of dementia care is the cost of caring for patients, either in nursing homes or their own homes.

In 2010, the annual tab for care in nursing homes and other institutions for dementia patients came out to $13,900 per patient. The bill for professional home health aides was an additional $5,700 per patient.

And then there’s the “informal care” provided by family members and friends who help loved ones with dementia do things like pay their bills and buy their groceries. The research team used two methods to calculate the value of all this care. In one, they estimated the “replacement cost” — what it would have cost to hire a professional to do the same work. In the other, they estimated the size of the paycheck these volunteers could have earned if they spent the same amount of time working at a paying job.

The two methods yielded quite different results. When using replacement costs as a guide, the total bill per dementia patient worked out to $41,689 per year, on average. When passed-up paychecks were used, the total rose to $56,290, according to the study.

The researchers used data from a nationally representative survey called the Health and Retirement Study to estimate that 14.7 percent of Americans over the age of 70 suffered from dementia. Combining that with U.S. census data, they calculated that the amount of money spent caring for Americans with dementia was about $109 billion in 2010. Adding in the value of unpaid informal care pushed the total up to between $159 billion and $215 billion. By comparison, direct spending adds up to about $102 billion a year for patients with heart disease and $77 billion a year for patients with various types of cancer, they wrote.

Spending related to dementia will only grow as Americans get older. If present trends continue, the total cost of dementia care will more than double by 2040, according to the report.

People with dementia are likely to have other health problems, such as a history of stroke, heart disease or a psychiatric condition — all of which add to their medical bills. (They are statistically less likely to have cancer.) In the study, the researchers did their best to exclude those other medical costs to arrive at a number that represented the economic value of dementia-related care.